By Michael Tetreault, Editor-In-Chief
Jan 14, 2013 2:18 PM – The online and offline chatter about the overall health benefits for any one patient inside a concierge medical practice has been well documented by bloggers, the media and even physician associations over the past many years. There is still quite a bit of mystery surrounding this topic but one recent interview and discussion between Concierge Medicine Today and a Fortune 50 Drug Corporation reveals some fascinating insight. According to a recent interview with an Executive at the company, patients who have a concierge physician are far less reliant on prescription medications than those patients at any traditional primary care or family practice. In some cases, concierge physicians can reduce the total amount of medication their patients intake by 50-95%, this according to surveys obtained from concierge/direct care physicians operating in the concierge medical movement across the U.S. [November 1, 2010 to February 1, 2011 – Internal Data © 2011].
Health System Pharmacy | “Technology is creating a system to identify patients in need of medication help at discharge.”
What does this mean for the drug companies promoting drugs and educating physicians about certain medications to concierge physicians? Our source continued to say that this drop in the use of prescription medication was immediately noticed by high-level executives within the company and caused a slight shift in the sales strategy among the sales reps in the field. That strategic thinking and sales strategy reduced the amount of time any one prescription sales rep spends calling on concierge medical practices, compared to a more traditional, insurance based medical practice.
There may however be a side to this story that is not so familiar to the drug manufacturers. Concierge medicine practices may actually help to improve medication compliance, which is the patient’s consistency in taking prescribed medications over time . In 2011, preliminary research was conducted by The Concierge Medicine Research Collective and Concierge Medicine Today. They found that among concierge physicians across the U.S., when physicians were asked to ‘ grade their concierge medical patients’ on medication compliance, ‘ 96.3% of the doctors indicated that 75% of their patients comply with prescription regimens all or most of the time.
When compared to traditional medical practices or insurance/MCO based medical practices, concierge medical doctors have more time to research the drugs they prescribe (up to 4 hours per day in some cases according to Concierge Medicine Today 2010 internal data) and these physicians are able to spend more time explaining the prescription usage, history and benefits. In fact, The Concierge Medicine Research Collective also found that in the majority of office visits conducted inside concierge physician practices in 2010, a single office visit with a concierge physician can last as little as 45 minutes and as long as 3 hours in some cases. Medication compliance is a patient health issue, since not taking medication may slow or prevent recovery, or even worsen the patient’s condition. However, poor compliance is also a topic that drug manufacturers pay attention to, since it means poor sales of prescriptions and refills as well.
In fact, a 2005 Harris Interactive report indicates that roughly half of all prescriptions for drugs meant to be taken on an ongoing basis are either not completed or are never filled in the first place. Surveys conducted over the past year (Jan 2010 to present) among concierge physicians by http://www.ConciergeMedicineToday.com indicate that ‘the most common types of phone calls concierge physicians receive from their patients were prescription drug renewal requests. These accounted for 35% of all calls while the other most common being Cold/Flu Symptoms (20%) and Back pain 15%.
When concierge physicians were asked ‘Do you see a difference in how well concierge patients follow through and/or comply with taking prescription medications, as opposed to patients you’ve treated in trad. practice?’ the following results were found:
67% – of respondents polled indicated that Yes! A Significant Difference;
28% – Some, but not a big difference; and
6% – No difference at all.
When these same concierge doctors were asked ‘If you’ve noticed your concierge patients do better when taking their Rx meds, what do you think accounts for this change?’ we found the following results:
• 38% – I follow up personally to ask about medication use and side effects, and to encourage compliance.
• 28% – I spend more time explaining the importance of medication compliance.
• 28% – The patient has more confidence in my recommendations and will follow them.
• 7% – Other.
Concierge physicians may indeed take a more conservative approach to prescribing multiple medications, but their high level of attention to patient care may at the same time promote greater medication compliance. Is one to presume that patients who have a concierge physician develop closer relationships with their doctors and therefore respond more positively to medical advice? That could be the case. The hallmark of concierge medical care is the doctor’s more personalized approach to treating individual patients, which in turn allows more time to research appropriate treatment alternatives and spend more time counseling and following up with patients. As the drug company executive noted, one outcome of concierge care is fewer prescriptions. However, the high proportion of prescription requests suggests concierge medicine patients may also exhibit higher levels of medication compliance. This is a topic we will explore further in the future.